Micro Man Flashcards
Gram negative ‘coliforms’
E coli, Klebsiella, Enterobacter, Proteus
Gram negative ‘coliforms’ sensitivity
Gentamicin
Extended Spectrum Beta Lactamases (ESBL) sensitivities
Temocillin, pivmecillinam (& meropenem)
Why is metronidazole not needed with pip-tazobactam or co-amoxiclav
they have anaerobic cover
Temocillin & aztreonam have no ______ or gram ______ cover
Temocillin & aztreonam have no anaerobic or gram positive cover
Anaerobes are generally sensitive to =
metronidazole (and co-amoxiclav, clindamycin, pip-tazobactam & meropenem)
Gram positives like Staph aureus (MSSA, MRSA), streps & enterococci are sensitive to
vancomycin (except VREs): use restricted to penicillin allergy or penicillin resistant strains
MRSA is resistant to all
beta-lactams (penicillins, flucloxacillin, pip-tazobactam,
cephalosporins & meropenem)
Beta-haemolytic streps (groups A C G) are sensitive to
penicillin & flucloxacillin
Pathogens in meningitis
pneumococcus, meningococcus and if > 60 listeria
pathogens in encephalitis
herpes simplex
what are pneumococci and meningococci similar sensitive to?
penicillin
why is ceftriaxone chosen in meningitis?
need for high CSF levels to maintained and the ease of dosing (twice a day) provides better cover for the rare strain that might have borderline sensitivity to penicillin
what is listeria resistant to?
cephalosporins
what is listeria sensitive to?
amoxicillin: high dose and frequent dosing
what is herpes simplex sensitive to?
IV aciclovir
pathogens in epiglottitis?
haemophilus influenzae, streptococci
pathogens in tonsilitis
group a streptococci
pathogens in sinusitis
pneumococcus
pathogens in acute otitis media
pneumococcus, haemophilus influenzae
amoxicillin has better absorption when given
orally
what are haemophilus influenzae sensitive to
amoxicillin (not penicllin)
why are life threatening haemophilus influenzae treated with ceftriaxone
for the rare cases of amoxicillin resistance
organisms in CAP
CAP Mild/moderate: pneumococcus, Haemophilus influenzae
CAP Severe: as above but possible coliforms and atypicals such as Legionella, Mycoplasma, Chlamydia pneumoniae,
Coxiella ;
Remember Staph aureus pneumonia post influenza and the PVL producing strains of Staph aureus that can produce severe pneumonia in children and young adults especially please contact micro/make clear on form to add extra tests for this
acute exacerbation of COPD organisms
Pneumococcus, haemophilus influenzae
HAP organisms
pneumococcus, Haemophilus influenzae and coliforms.
Legionella can be hospital acquired.
Co-amoxiclav provides cover for most…..
Haemophilus influenzae & coliforms for those with severe infection (not
ESBLs or CPEs though)
why is doxycycline used in pneumonia
for atypical cover
native valve acute
Staph aureus: take 2 sets blood cultures & start antibiotic within the hour
Native valve subacute
viridans streptococci, enterococci :3 sets blood cultures 6 hours apart if patient stable
Prosthetic valve
MRSA (resistant to flucloxacillin and all beta lactams); coagulase negative staphylococc
Indolent presentation________/_____ more likely: synergistic ____/_____ (1mg/kg bd) pending culture results
Enterococci/streps
amox/gent
Coagulase negative staphylococci sensitivity
vancomycin, gentamicin (1mg/kg bd) & rifampicin (started 3-5 days after vancomycin) is used to
ensure cover, killing & penetration
most enterococci are sensitive to ______
amoxicillin
peritonitis/biliary tract sepsis/intrabdominal organisms
polymicrobial coliforms
anaerobes
enterococci
Spontaneous bacterial peritionitis
coliforms +/- anaerobes, sometimes strep pneumonia
anaerobe sensitivity
metronidazole
coliform sensitivity
gentamicin and aztreonam
ESBLs sensitivity
> resistant to most penicillins & cephalosporins including aztreonam, co-amoxiclav & pip-tazobactam
> sensitive to temocillin (& meropenem available on infection specialist advice only)
> Sensitivity of ESBLs to co-trimoxazole is unpredictable
organisms in female uncomplicated lower UTI
coliforms
enterococci
male (no catheter) organisms
coliforms
enterococci
complicated UTI
coliforms
pseudomonas aeruginosa
enterococci
why isnt nitro used in complicated UTI
no kidney tissue penetration & is not excreted in urine in renal impairment
cellulitis organisms
Staph aureus, group A & other beta-haemolytic streptococci
Diabetic foot acute
Staph aureus
Diabetic foot acute on chronic polymicrobial
Staph aureus, coliforms & anaerobes
Flucloxacillin will cover …..; so ….. is not required in addition
beta-haemolytic streptococci ( A C &G)
penicillin
